Of 1,500 consecutive deliveries, there were 41 term infants with suspected sepsis in association with a positive culture for group B streptococci (GBS) from either the infant soon after birth, or the mother's urine routinely collected three days postpartum. A statistically higher incidence of pneumonia was found in these infants as compared to matched controls. Infants born to mothers with GBS in the urine had a high incidence of suspected sepsis (43.6%) as well as a high incidence of pneumonia (38.6%). We conclude that term infants colonized at birth with GBS or born to mothers with GBS isolated from their urine are at high risk of having pneumonia.

Bacteriuria↗

PubMed1976

Intrauterine growth retarded infants. Correlation of gestational age with maternal factors, mode of delivery, and perinatal survival.

Fifty-eight infants of 3332 deliveries (1.7%) were found to be growth retarded (IGR) at birth. For purposes of analysis, the infants were divided into 2 groups according to gestational age at delivery: Group I infants were delivered between 38 and 43 weeks' gestation, and Group II infants were delivered between 28 and 37 weeks'. The infants at greatest risk are those who manifest chronic intrauterine fetal distress associated with prematurity. Asphyxia was evident in 9 of 19 infants (47%) in Group II as compared to 9 of 36 infants (25%) in Group I. The premature IGR infants delivered by low forceps and cesarean section had higher 1- and 5-minute Apgar scores than those delivered spontaneously. There was a five-fold increase of intrauterine demise and a two-fold increase of neonatal deaths in Group II IGR infants as compared to the non-IGR premature infants. In the management of IGR, a combined obstetric-pediatric approach is important. A higher index of suspicion, appropriate evaluation, earlier diagnosis, and expedient delivery are essential if the prognosis for an IGR infant is to be improved.

Apgar Score↗

PubMed1968

Effect of chest strapping on the flow-volume curve and time constant of lung.

Explore the source record for details and available documents.

Leukemia↗

PubMedDate not supplied

Extracorporeal membrane oxygenation as a means of stabilizing and transporting high risk neonates.

Term or near term newborns whose severity of cardiac or respiratory failure makes them candidates for extracorporeal membrane oxygenation (ECMO) are often too unstable to be safely transported to an ECMO-competent center. Faced with a large military and civilian referral population that is distributed across the entire continental United States, the authors have addressed this dilemma by developing a transportable ECMO system that can be taken to the referring hospital in a small transport aircraft. This system was on hand, but was not required, to stabilize and transport the infant in question in four cases. All had uneventful transports. Thirteen infants were placed on ECMO at their referring hospitals, one of whom died shortly after the institution of bypass. The remaining 12 infants were stabilized and transported successfully on ECMO over distances ranging from 17 to 1,437 miles, with 11 of these being long distance air transports. Four patients are long-term survivors. The authors conclude that a properly configured and managed ECMO system can effectively stabilize and transport even extremely ill neonates if the pertinent physiologic and aeromedical considerations are addressed.

Aerospace Medicine↗

PubMedDate not supplied

High frequency ventilation--the relationship between ventilator design and clinical strategy in the treatment of hyaline membrane disease and its complications: a brief review.

Progress in the application of techniques of HFV to clinical settings has been hampered by a lack of comparative data. Ventilator design and/or strategy place clear limitations on the effective and safe use of these devices. There is a definite need to develop clear therapeutic goals for HFV, to define the operating characteristics and limitations of each device, and to develop effective and safe strategies for their use in various clinical settings. Only then can adequate controlled clinical trials be performed and the role of these techniques be firmly established.

Cardiac Output↗